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HomeMy WebLinkAboutApproved Minutes of June 26, 2024 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To promote and protect health, enhance quality of life, and preserve the environment for everyone in Orange County. THE ORANGE COUNTY BOARD OF HEALTH MET ON June 26, 2024, at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Alison Stuebe—Vice Chair, Keith Bagby, Bruce Baldwin, Brian Crandell, Commissioner Amy Fowler, Davia Nickelson, Lee Pickett, and Tony Whitaker. As Aparna Jonnal was not present, Alison Stuebe served as chair for the evening's meeting. BOARD OF HEALTH MEMBERS ABSENT: Aparna Jonnal — Chair, Shielda Rodgers, and Rachel Royce. STAFF PRESENT: Quintana Stewart, Health Director; Dana Crews, Community Health Services Director; Victoria Hudson, Environmental Health Director; Carla Julian, Public Health Nursing Director; Dr. Stephanie George, Dental Services Director; Ashley Rawlinson, Compliance Manager; Thomas Privott, Environmental Health Supervisor; Libbie Hough, Communications Manager; Alex Rimmer, Environmental Health Supervisor; Tameka M. Faulkner, Health Social Worker ll; Martin O'Malley, Family Planning Coordinator Nurse; and Jean Phillips-Weiner, BOH Strategic Plan Manager. GUESTSIVISITORS PRESENT: Anna Myronova and Desmond Wallace. I. Welcome New Employees Quintana Stewart, Health Director, introduced the new employees in attendance: Martin O'Malley— Family Planning Coordinator Nurse and Tameka Faulkner— Health Social Worker with Family Home Visiting. II. Public Comment for Items NOT on Printed Agenda: None. III. Board Comments Dr. Davia Nickelson Dr. Nickelson shared that the free dental clinic and health fair hosted at Pine Grove Missionary Baptist Church on June 15t" was a success. Thirty-five people at the fair had dental work performed and there was a great turnout. Dr. Nickelson went on to comment on the state budget, saying that there have been no proposed increases in Medicaid reimbursement rates for dental services, and no increases have been made since 2008. This is of particular concern because North Carolina ranks in the bottom third of all states for Medicaid reimbursement for children's dental services. She encouraged people to reach out to their representatives to encourage them to increase Medicaid dental service reimbursement rates. S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 1 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 In response to Dr. Stuebe's question about what body sets reimbursement rates, Dr. Nickelson replied that Medicaid sets the rates, but the legislature has the power to allot additional money for reimbursement and to encourage Medicaid to increase the rates. Commissioner Fowler shared that Senate Bill 630 proposes to cap the state income tax rate at 5%, which would impact that state's ability to fund everything — healthcare, education, and all the things that make a vibrant community. She encouraged everyone to reach out to their state senators and representatives. Dr. Nickelson added that the money spent to cover emergency room care for preventable dental services —$3.4 billion annually— could be reallocated to help fund prevention services and provider training. Tony Whitaker Mr. Whitaker announced that the US Surgeon General recently issued a report that firearm violence in the USA is a public health crisis and that he was happy to see this kind of framing at the national level. Keith Bagby Mr. Bagby shared that he and Dr. Jonnal had recently been featured in a radio interview for WCHL/Chapelboro's Wellness Wednesdays, speaking about family health and wellness. He added that Wellness Wednesdays are featured once per month and cover a variety of health topics, and invited board members to let him know if they are interested in participating. Commissioner Fowler asked if the program is always hosted on Wednesdays, to which Mr. Bagby answered yes, but it is only 15 minutes. In response to Dr. Pickett's question, Mr. Bagby confirmed that the interviews air live. Dr. Brian Crandell Dr. Crandell commented that in the past week, he's noticed that transportation has been a significant issue for many of his patients, inhibiting their ability to receive their cancer treatment. He also noted that for foster family situations, barriers to transportation can lead to snowballing problems and inhibit reunification. In response to Dr. Stuebe's question about the Mobile on Demand (MOD) program, Ms. Stewart explained that it works similarly to Uber, but for a flat fee. Dr. Stuebe said that Medicaid- provided transportation often requires a day or more's lead time, meaning it wouldn't be useful for a patient experiencing a transportation emergency. Mr. Bagby asked Dr. Crandell if he referred any of his patients to Orange County Public Transportation (OPT) Services. When Dr. Crandell said he was not familiar with this service, Ms. Stewart said she would share information about it with him after the meeting. Dr. Alison Stuebe Dr. Stuebe said that the heat is a huge public health issue, leading to an increase in interpersonal violence due to shorter tempers as well as more deaths for those who are unsheltered compared to in cold weather. She asked if there were any initiatives in Orange S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 2 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 County to address heat. Ms. Stewart shared that Libbie Hough, Communications Manager, recently joined a task force to address heat as a public health issue. Ms. Hough shared that there are currently five cooling centers in Orange County, including the libraries, and that the task force is a joint effort between the Climate Sustainability Office, the County Public Information Office (PIO), Orange County Health Department, and Emergency Management. IV. Priority Committee Updates Behavioral Health Committee Dr. Baldwin shared that the committee had met two nights ago, and Jean Phillips-Weiner, Board of Health Strategic Plan Manager, had presented on several topics, including data for suicide and mental health provider demographics. He also observed that EMS calls related to suicide noticeably increased during the COVID pandemic. The committee had discussed possible areas for focus, honing in on two topics: 1. Increasing the number of mental health providers, especially diverse providers; and 2. Screen time, social media use and mental health. Dr. Baldwin noted that excessive screentime appears to be detrimental to young people's wellbeing and that there is a particular interest in focusing on school-aged children, as they are a `captive audience', and interventions could be put in place to limit smartphone and screen use during school hours. He added that, anecdotally, you'd expect a child to learn better when they're not on their phone all class. Commissioner Fowler added that the largest increase in suicide ideation appears to have occurred in adult males, but based on the data available, most mental health providers in Orange County are female, creating a mismatch. Dr. Crandell echoed that this mismatch concerns him and that he felt it could present a potential limit on culturally appropriate care. He shared that the committee attempted to consider suicide demographics by race, however, much of the data specific to Orange County was suppressed to preserve privacy, as the numbers are quite small. He added that as the committee digs into screentime, they plan to consider the equity impact of any initiatives or policies they may advocate for. Commissioner Fowler said that to help guide decision making, the committee reviewed the Vital Conditions Framework and the Health Impact Pyramid, which define the seven elements necessary for thriving and posit methods for impacting the largest number of people. She provided a quick overview of the elements of the Vital Conditions Framework. Dr. Stuebe expressed appreciation for the Vital Conditions Framework, saying that she previously worked on a paper applying it to maternal mental health. She added that the question of cultivating spaces for social belonging is interesting. Commissioner Fowler said the goal is to address screentime through a positive lens, focusing more on increasing engagement and mindfulness rather than taking a prohibitive `don't do it' approach. Mr. Whitaker commented that he recently read an article from The Atlantic saying that the evidence on screentime is not conclusive. He wondered if there was empirical data about the benefits or harms of screentime and social media, particularly any longitudinal Randomized Controlled Trials. Commissioner Fowler said that she is not sure if the data are there yet, as there's only been smartphones for about ten years, but the goal would not be to eradicate screentime, but to reduce it and supplement with healthier options —for example, physical activity or face-to-face socialization. She added, on a personal note, that she recently saw a patient who was clearly dealing with mental health issues that were being exacerbated by excessive screentime. S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 3 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 In response to Dr. Stuebe's question about inviting a faculty member from UNC Gillings School of Global Public Health, Karl Johnson, to a future meeting, Ms. Stewart said that the plan is to invite him to present to the Behavioral Health committee, if not the full board, and explained that Dr. Johnson has previously done research on the topic of screentime and social media, and recently helped pilot a screen reduction program for schools in Granville County. Ms. Stewart went on to say that NC Senator Jim Burgin is also trying to pass a bill to limit smartphone use in schools, so it appears that there is interest in exploring smartphone restrictions in schools and better data may be forthcoming. Access to Care Committee Dr. Pickett provided the update for the Access to Care Committee. She said that Lindsey Shewmaker, Human Services Manager from the Department of Social Services (DSS), came to present to the committee on Medicaid Expansion, DSS efforts to reach eligible folks who are not enrolled, and initiatives to promote Medicaid education and uptake. Dr. Pickett added that the goal of the committee is to target systems, rather than neighborhoods or geographic areas, to help reach those who are eligible for Medicaid but might not know it. She shared that one system the committee has identified is the Health Department, which does not have a way to automatically connect Medicaid-eligible patients to DSS for assistance with enrollment. As such, Ms. Stewart is in contact with DSS to help set up a new system to address this gap, while Dr. Royce is planning to make a logic model to assist with outreach. The committee also spoke in detail about special populations who may be difficult to reach or who may struggle with accessing care even with insurance. Mr. Bagby asked if the committee had considered reaching out to any other clinics to encourage them to adopt a similar system of automatically connecting eligible patients to DSS to assist with Medicaid Enrollment, for example reaching out to Piedmont Health Clinic. Dr. Pickett said that the committee did not discuss that, though they did touch on the difference between enrollment at the Whitted Clinic vs the Southern Human Service Center (SHSC), as SHSC shares a building with DSS, while Whitted does not. Ms. Stewart chimed in to say that the Piedmont Health Clinic likely has staff members whose job it is to assist with Medicaid enrollment, which the health department currently does not have. Connections to Community Support Committee The Connections to Community Support Committee will next meet in mid-August. V. Approval of the June 26, 2024 Agenda Motion to approve the agenda of the June 26, 2024 BOH meeting was made by Commissioner Amy Fowler, seconded by Dr. Brian Crandell, and carried without dissent. VI. Approval of May 22, 2024 Minutes Dr. Pickett requested a minor modification to the wording of one of her statements, as she felt it had not been accurately captured in the minutes. S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 4 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 Motion to approve the minutes of the May 22, 2024 BOH meeting with this revision was made by Commissioner Amy Fowler, seconded by Dr. Lee Pickett, and carried without dissent. VII. Educational Sessions A. Alliance Health Update Amy Perry, Senior Vice President of Population Health and Care Management for Alliance Health, provided a high-level overview of the Alliance Health Plan Program and initiatives. Some highlights of her presentation are below: • As the presentation was meant to be an overview of all Alliance Health services, Ms. Perry offered for herself or a colleague to present at a future Board or committee meeting on Alliance's work on specific topics of interest, such as health equity or bolstering the provider network. • Ms. Perry explained Alliance's purpose of providing targeted care for individuals on Medicaid with complex needs, sharing that Alliance has specialty knowledge to help with care for persons on Medicaid who have a severe mental illness, traumatic brain injury (TBI), intellectual or developmental disability (IDD), or substance use disorder. • Alliance's new Tailored Plan will launch on Monday July 1st, and will provide additional support (i.e., supporting physical health and pharmacological needs) to patients in a way that is integrated with the existing behavioral health treatment plan. • Orange County accounts for 3% of Alliance's total service population, but Medicaid Expansion will grow these numbers. Dr. Crandell asked how many total people in Orange County are currently served by Alliance, to which Ms. Perry replied around 5,550 (3% of-185,000). • Traditionally, initiatives to address health equity have been distributed across the various programs offered by Alliance, but Alliance has recently hired a director of health equity and is now working to consolidate these initiatives into a single integrated approach. Mr. Bagby expressed that he would like to meet the person in charge of health equity at Alliance, Dr. Shameka Fairbanks. • Ms. Perry mentioned that Alliance is focusing on supporting and engaging mental health providers within the provider network to help increase the supply. She added that they are also working to perform proactive Medicaid Expansion outreach, as their service population is entirely made up of individuals with Medicaid coverage. • Alliance is working to build a more value-based approach to care delivery, increasing partnerships with various practices and working to make care higher quality rather than just focusing on paying claims. • Ms. Perry shared that Alliance is performing predictive analytics on population health data to help identify populations which are at rising risk, though she clarified that they were still early in this process and working at the high-level view of their service population. In about 3-6 months. Alliance should have data more specific to the population in Orange County. Preliminarily, she shared that Orange County has a different breakdown of disparities and chronic conditions as compared to other counties in the Alliance service area, and that Orange County sees a higher need for urgent support (-25% in Orange vs. -10% in Wake). Dr. Stuebe noted that, because Orange County has a small population, this could be an influence of small sample bias. • Alliance is working to close quality gaps and help their service population improve both preventative care and medication management/adherence. Ms. Perry shared that S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 5 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 Alliance has a new Diabetes management program which is serving as a pilot for chronic care management programs. She added that the chronic conditions which Alliance focuses on are selected by the state. In response to Mr. Whitaker's question, Ms. Perry shared that chronic pain and pain management is not currently covered, but she would like to see it included and to tease out what's driving chronic pain vs. treating symptoms. • Ms. Perry shared that Alliance has a strong focus on community integration, including financial security, employment support, and housing stability. She said that health literacy and education is a priority, as is creating a supportive built environment—for example, the presence or absence of sidewalks and adequate lighting impacts people's reported feelings of safety. Alliance's Tailored Plan will also offer transportation support, including emergency transportation for oncology patients. • Alliance offers several services for people in crisis. Alliance provides its own mental health crisis line, similar to 988, as well as the Mobile Outreach Response Engagement & Stabilization (MORES) program, which provides follow up and support for approximately nine months after an individual experiences a crisis. • Ms. Perry provided an overview of the interdisciplinary care team, saying that Alliance is looking to add a nutritionist in the next fiscal year. In response to Commissioner Fowler's question, Ms. Perry explained that the providers within the interdisciplinary care team do work one-on-one with clients, though each client has a care manager who serves as their primary point of contact and facilitates connections with other providers in the care team. The interdisciplinary team also provides strategic guidance for Alliance. • Alliance has coordinators to assist with transitional care, including transitioning out of behavioral and physical health hospitals. They also have liaisons based in correctional facilities to provide support as individuals transition out of incarceration. • Commissioner Fowler asked how Alliance assists with food insecurity, to which Ms. Perry replied that they have community health workers who provide support beyond a resource list, for example assisting with transportation and completing forms. Commissioner Fowler noted that, as a provider, giving people a list of resources or even helping sign them up for Supplemental Nutrition Assistance Program Electronic Benefits Transfer (SNAP EBT) often feels insufficient and she wishes they could provide cash. Ms. Perry said that Alliance is not permitted to provide cash to clients, but that they are piloting a food home delivery program. • In response to Dr. Pickett's question about how Alliance prioritizes issues within the Social Determinants of Health when a patient is struggling to meet multiple needs, Ms. Perry replied that it is tailored to the individual and based on their concerns, priorities, and energy to address any given issue. • In response to Commissioner Fowler's question, Ms. Perry explained that Alliance has a robust housing program and another representative from Alliance could speak to their services more in-depth. She said that Alliance builds partnerships with landlords to invest in community-based housing, helps provide financial support for housing programs, and provides individuals with subsidies and connections to actual housing. • Dr. Stuebe asked how to refer an individual to Alliance, as she has a patient on Medicaid struggling with complex mental health needs. Ms. Perry explained that the Department of Health and Human Services (DHHS) uses an algorithm to identify potential Alliance clients based on their Medicaid claims and utilization patterns and, unfortunately, there is currently no way for individual providers to directly refer a patient into Alliance. • In response to Mr. Bagby's question about whether Alliance has a relationship with Family Success Alliance, Dana Crews, Community Health Services Director, replied yes. Ms. Perry added that Alliance does not receive grants, as they are funded entirely through Medicaid, but receives allocations to support community programs. S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 6 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 • In response to Dr. Nickelson's question, Ms. Perry explained that there are a total of four managed care plans like Alliance in North Carolina, and each county in the state is served by one of the four programs. Commissioner Fowler added Alliance's board includes at least one representative from the Board of County Commissioners (BOCC) for each county served. • Dr. Crandell mentioned that he was interested in learning more about any bottlenecks Alliance might identify in the mental health provider network, as finding these may assist with connecting people to mental health providers. Ms. Perry clarified that this is examined by Provider Network Services, which also examines locations of providers, whether they're accessible by public transportation, whether they are culturally appropriate, and other similar gaps. • Commissioner Fowler mentioned that one quality measure for mental health providers is the numbers for completing a seven-day warm handoff to a mental health provider when an individual is discharged from a psychiatric hospital, which was low about a year ago; Ms. Perry said that these numbers are still low, which could reflect an insufficient number of providers but may also reflect an issue with data reporting requirements. B. Annual Communicable Disease Report Carla Julian, Public Health Nursing Director, presented the annual communicable disease report for Orange County. Because of changes to accreditation requirements, this presentation put most of its focus on atypical incidence of communicable diseases. Some highlights of her presentation are below: • Over the past year, atypical incidence was observed in Orange County for Vibrio, Hepatitis B, and syphilis. • Victoria Hudson, Environmental Health Director, clarified that the two Vibrio cases observed in Orange County originated when individuals dined at an unlicensed location outside of Orange County. • Ms. Julian shared that there were six recent cases of Pertussis (Whooping Cough) in the last few weeks of the school year. • Hepatitis B cases increased by about 15 compared to previous years. Ms. Julian clarified that these cases are largely seen among individuals who immigrated to the United States and were neither vaccinated for Hepatitis B nor aware that they had contracted it; typically, it is screened for and identified during the immigration process. She added that Hepatitis B is generally a chronic illness. • While reviewing vector borne illnesses, such as Lyme Disease, Ms. Julian explained that the numbers do not accurately reflect the cases, as two appointments are required to confirm diagnosis of vector borne illnesses, and many patients fail to show up for the second appointment. • Demand for the COVID vaccine at the health department has been low. The health department still offers free antigen testing and has free rapid COVID tests available. Ms. Stewart added that the bridge program to assist with COVID vaccine cost among uninsured individuals will be ending in August. • Case numbers for measles and syphilis are both trending in the wrong direction, though as of this meeting there have been no reported cases of measles in Orange County. However, there were two cases of congenital Syphilis. Ms. Julian added that sexually transmitted infection (STI) cases are investigated by communicable disease teams at the state level, rather than the county level. • Commissioner Fowler asked if syphilis cases are generally evenly distributed or if they tend to cluster. Ms. Julian invited Desmond Wallace, an MPH student from UNC Gillings, S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 7 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 to share his perspective, as Mr. Wallace assisted the communicable disease team with presentation slides on syphilis. According to Mr. Wallace, syphilis rates are trending up nationwide (-50% increase nationally since 2018)while the southern states are seeing an 80-90% increase. Looking within North Carolina, that he compared syphilis incidence between Orange and Rowan counties (as they are comparable in population size and demographics) and found that Orange is seeing about 25-50 cases per year, while Rowan is seeing 50-75 cases per year. Currently, there are no CDC guidelines for syphilis testing at the national level; Mr. Wallace suggested that the state or a county could set their own guidelines for syphilis testing. • In response to Mr. Bagby's question about the upward trend in syphilis cases, Mr. Wallace explained that poverty and STIs tend to be comorbid, and a higher poverty rate typically reduces access to sexual health resources and thus increases STI incidence. • Congenital syphilis cases typically occur when prenatal care is delayed, absent, or incomplete, or when the newborn is incorrectly evaluated for syphilis. It is a goal to target education and communication campaigns promoting prenatal care for patients and congenital syphilis testing for providers. • On August 91h, the health department is hosting a Measles Symposium for Healthcare Providers to help provide measles education. The event will be hosted in the Donna Baker Meeting Room at Whitted Human Services Center. • The number of children with vaccine exemptions is increasing, though there is not a noticeable increase in medical exemptions. Mr. Bagby asked if children can enroll in public schools without receiving their vaccines, to which Ms. Julian replied that students are permitted to enroll, but they must either get in vaccine compliance or apply for an exemption within 30 days. In response to Dr. Pickett's question, Ms. Julian explained that she is unsure about what all the nonmedical exemptions are, but they include both religious and ideological exemptions. Dr. Pickett clarified that individuals do not have to be a member of a specific religion to claim religious exemption. • Dr. Stuebe mentioned a recent paper that explores the relationship between substance use and congenital syphilis, saying that individuals who use opioids or other illicit substances have significantly higher rates of congenital syphilis largely because their use of substances leads them to delay or avoid prenatal care in an effort to avoid having their substance use detected, which causes the syphilis to also go undetected. She added that poverty, homelessness, substance use, and poor health outcomes such as stillbirth are all intertwined. Vill. Reports and Discussion with Possible Action A. Ad Hoc Committee: Local Well Rules On behalf of Chair Jonnal, Dr. Stuebe called for the formation of an ad hoc committee to review and evaluate the Orange County local well rules as follow up to the recent adjudication hearing. Dr. Baldwin, Mr. Whitaker, and Dr. Crandell volunteered to serve on the committee. Because Dr. Rodgers had previously expressed interest in the well rules, it was suggested that Ms. Stewart invite her to serve on the committee as well. Motion to form the committee with the aforementioned volunteers was made by Commissioner Amy Fowler, seconded by Dr. Bruce Baldwin, and carried without dissent. S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 8 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 B. Media Items Libbie Hough, Communications Manager, presented the media packet to the board. Topics included the NC Masking legislation, which had been vetoed by Governor Cooper, and an article acknowledging UNC Hospitals as a leading hospital for addressing healthcare needs for insufficiently served populations. Ms. Hough also mentioned recent legislation around the legalization of medicinal cannabis in NC. Media items were in the packet, which focused on Orange County's events, our involvement in various efforts, and various public health topics. C. Health Directors Report Ms. Stewart presented her report to the Board. Below are brief highlights of her report. • Each board member received a new copy of Suggested Rules and Procedures for Local Government Boards, a guidebook for local appointed boards based on Robert's Rules of Order to help provide training and ensure the board follows suggested procedure. • Ms. Stewart drew board members' attention to the upcoming training by the Association of North Carolina Boards of Health, which will be held on July 22" • In reference to the evening's presentation on communicable diseases, Ms. Stewart provided board members with two one-page information sheets from the CDC, one on Pertussis and one on Rabies. • Ms. Stewart shared that many counties in NC with large populations of dairy and poultry farms have begun testing their stray and feral cat populations for H5N1 Influenza, though Orange County has not yet been affected. • Per Ms. Perry's presentation, as of July 1st, the Alliance Tailored Plan will be launching to better serve community members on Medicaid with complex behavioral health needs. • The BOCC passed the 2024-2025 budget. Ms. Stewart explained that while the Health Department saw a $50,000 reduction in the operating budget, the budget still provides well for staff, including a 4% cost-of-living wage increase and sustaining annual merit pay increases. • Retiring County Manager Bonnie Hammersley's retirement celebration was held earlier that day, and it was announced that Deputy County Manager Travis Myren has been promoted to the role of County Manager. • The Attorney General has reached a new opioid settlement with Kroger, which can amount to up to $360,000 more in settlement funds for Orange County over the next ten years. Mr. Bagby asked about the recent community opioid meeting and confirmed that this would be an annual event. He then asked how attendees were to be updated on the meeting results, to which Ms. Stewart explained that all attendees who had signed in at the meeting would receive an email update once new measures go into place, and that information would also be shared on the Orange County website. She added that Tonya Stancil, Harm Reduction Coordinator, and Ms. Hough are working to update the website page on opioids. Mr. Bagby asked if the Opioid Advisory Committee had added a representative from housing to which Ms. Stewart explained that this was up to the BOCC. • As mentioned by Ms. Hough, the recent bill to prohibit masking in public was vetoed by Governor Cooper. Ms. Stewart said that this legislative session has been one of the most interesting and active short sessions of her career. She also noted that the Health Director's Association contracts for a lobbyist as a legislative consultant. Commissioner Fowler and Dr. Stuebe mentioned several recent bills that contained measures unrelated S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 9 MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2024 to the title of the bill, such as a senate bill purporting to focus on citizen-only voting but including measures aiming to cap state income tax. • Ms. Stewart continues to work on the Health Department Strategic Plan, and shared that leadership is in the process of finalizing department values, with input from staff. IX. Adjournment A motion was made by Mr. Keith Bagby to adjourn the meeting at 8:56 p.m., was seconded by Commissioner Amy Fowler, and carried without dissent. The next Board of Health Meeting will be held August 28, 2024, at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m. Respectfully submitted, Quintana Stewart, MPA Orange County Health Director Secretary to the Board S:\Managers Working Files\BOH\Agendas &Abstracts\2024 Agenda and Abstracts/ June Page 10